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City of Santa f a 02012 - <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />"7 <br />201 I? 17 ? 'q= 14 -- — <br />Please complete this form when the attached agreement and all <br />SMA <br />amendments (if any) are no longer in effect. 11r A <br />EP ICIL <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement withC..fOf@� <br />No. N-2012-035 was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Z9,�2 �7rgLe�GS <br />Phone/Ext.: // C <br />Signature: –� — <br />Date: �GI�f1/ZoJ� <br />t <br />Revised 08-2310 <br />